(for
convenience, print out a hard copy to submit with your payment)
Name________________________________________________________
Address______________________________________________________
City__________________________________State_________Zip________
Email_________________________________________________________
I hereby apply for membership in the Colonial Coin Collectors Club.
Enclosed is $_____ in payment for dues.
Membership
type:
____Regular $25.00
____Junior (under 18 years of age) $10.00
Collecting
interests:____________________________________________
____________________________________________________
How
did you learn about C4?______________________________________
_____________________________________________________
Send
check made payable to Colonial
Coin Collectors Club or C4 to:
Charlie Rohrer ( RohrerC@cadmus.com)
C4 Treasurer
PO Box 25
Mountville, PA 17554